Hypothermia-associated acute pancreatitis: A multicenter prospective observational study

Hypothermia-associated pancreatitis lacks comprehensive understanding owing to limited studies exploring its mechanism, epidemiology, risk factors, and outcomes. We aimed to investigate the frequency, characteristics, and predictive factors associated with the development of acute pancreatitis in patients with accidental hypothermia.

This study comprised a post hoc analysis of data from a multicenter prospective observational study (ICE-CRASH study) conducted in 36 tertiary emergency hospitals in Japan. Patients aged ≥18 years with core body temperatures ≤32°C admitted to emergency departments between 2019 and 2022 were enrolled. We identified patients who developed acute pancreatitis within 1 week of admission and described their characteristics. Age, vital signs, and blood gas analysis data were analyzed as potential predictors of acute pancreatitis using receiver operating characteristic (ROC) curve analysis.

Of 421 eligible patients with accidental hypothermia, 16 (3.8%) developed acute pancreatitis within 1 week. The age distribution of patients with acute pancreatitis showed bimodal peaks around 50-80 years. Patients with acute pancreatitis had a higher proportion of alcohol consumption than those without acute pancreatitis. ROC curve analysis showed age and pH as significant factors; however, their predictive power was not high.

The incidence of acute pancreatitis was 3.8% in patients with accidental hypothermia with core body temperatures ≤32°C. An association was found between the development of acute pancreatitis and alcohol consumption. No strong predictors of acute pancreatitis were identified.